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How is pyelonephritis treated?

Aug 19, 2017

The purpose is to relieve symptoms, control infection, remove infection focus, correct abnormal or reflux of urinary tract, prevent complications, prevent recurrence and reduce the damage of renal parenchyma.
1. general treatment: encourage patients to water more, diligent micturition, do not hold back, in order to reduce the osmotic pressure, improve the phagocytic function, rinse the bacteria in the bladder. There is fever and other systemic infection symptoms, should stay in bed. When there is irritation of the bladder, bicarbonate of soda can be used to clear urine and relieve symptoms. There is a bladder ureter reflux, can be "two times urination", that is, 5 minutes after urination row again.
2. acute pyelonephritis
Light weight: oral antibiotics treatment, the course of treatment for 14 days. Collect urine for bacterial culture and drug susceptibility testing before taking the drug. First of all, the choice of gram negative bacilli effective drugs such as quinolones, semi synthetic penicillins and cephalosporins antibacterial drugs. After 72 hours of treatment, according to the efficacy evaluation, if the symptoms are improved, effective antibiotics should be selected according to the drug sensitivity test. After 14 days of urine treatment, if the urine is still positive, then choose sensitive antibiotics to continue treatment for 6 weeks.
Systemic poisoning symptoms: intravenous antibiotics, if necessary, drug combination, culture negative in the normal body temperature, the improvement of clinical symptoms, urine, changed to oral medication, complete not less than 2 weeks. We should pay attention to whether the occurrence of pyonephrosis and perirenal abscess and other complications.
Infant patients: newborns and infants and children under 5 years old with acute pyelonephritis mostly with urethral deformity and dysfunction, it is difficult to eradicate, but some disorders such as vesicoureteral reflux may disappear with age. A one-time or focal scar formation in the renal tissues of repeated urinary tract infection, and even affect the kidney development in recent years that before treatment as far as possible to do the urine culture check urine culture should be discontinued after second, fourth, sixth weeks, in order to discover and deal with.
3. chronic pyelonephritis
Correct and remove the predisposing factors: the key to the treatment of chronic pyelonephritis is actively looking for and removing the predisposing factors, possible abnormalities, calculi, obstruction and reflux and urinary system are correct and remove the patient's anatomy.
Anti infection treatment: acute attack with acute pyelonephritis, after taking urine samples for bacterial culture, immediately give the gram negative bacilli effective drug treatment. If the bacterial resistance or lesion formation, blood flow is poor, the concentration of antibiotics in the focus is not enough, can be treated with a larger dose of bactericidal type of antibacterial drugs, the course of treatment for 6 weeks. If the obstruction factor is difficult to be relieved, the appropriate antimicrobial agents should be selected for 6 weeks according to the sensitivity of the drug, and long term low dose therapy may be considered.
Glucocorticoids and nonsteroidal anti-inflammatory drugs can reduce the development of renal scarring caused by infection.
Protection of renal function: elevated blood pressure can speed up the deterioration of renal function, so long-term treatment of chronic pyelonephritis should pay attention to control blood pressure. Improve microcirculation, improve blood supply of kidney, prevent further damage to renal function. Patients with renal failure should be treated with a low protein diet according to the treatment of chronic renal failure, and renal toxic drugs should be banned.

treatment of pyelonephritis
treatment of pyelonephritis

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